An Ostomy is a surgically created opening in the body for the discharge of body wastes. A stoma is the actual end of the large or small intestine or ureter that can be seen protruding through the abdominal wall. The most common specific types of ostomies are colostomy, ileostomy and urostomy.
A colostomy is a surgically created opening of the colon (large intestine) which results in a stoma. A colostomy is created when a portion of the colon or the rectum is removed and the remaining colon is brought to the abdominal wall.
An ileostomy is a surgically created opening in the small intestine, usually at the end of the ileum. The intestine is brought through the abdominal wall to form a stoma.
A urostomy is a surgical procedure which diverts urine away from a diseased or defective bladder. The ileal or cecal conduit procedures are the most common urostomies. Either a section at the end of the small bowel (ileum) or at the beginning of the large intestine (cecum) is surgically removed and relocated as a conduit for urine to pass from the kidneys to the outside of the body through a stoma. It may include removal of the diseased bladder.
After a colostomy or ileostomy, feces leave the patient's body through an opening in the abdominal wall. External and internal views of stoma and bowel resection are illustrated in FIG. 1A.
After urostomy urine leave the patient's body through an opening in the abdominal wall. An example of a Urostomy is shown in FIG. 1B.
Stoma may be required, for example, following surgical removal of a section of the colon or the small bowel, such that it is no longer possible for the intestinal content to pass out via the anus (e.g. due to colon cancer, diverticulitis, trauma, inflammatory bowel disease, etc.) or following an operation on a section of the bowel which then needs to be rested until it heals. In the latter example, the stoma is often temporary and is reversed at a later date, once healing is complete.
Following a stoma operation, an artificial method of controlled fecal or urine evacuation is required. Such methods may involve non-irrigation systems, involving use of a pouch in which feces or urine is collected (as illustrated in FIG. 2B); or irrigation systems, wherein the bowel is washed out without the use of a pouch.
For irrigation systems, a removable closure, such as a gauze cap, is placed over the stoma, and irrigation is scheduled for specific times. To irrigate, a catheter is placed inside the stoma, and flushed with water, which allows the feces to come out of the body into an irrigation sleeve. Irrigation is generally performed once a day or every other day, though this depends on the person, location of the stoma, their food intake, and their health.
Non-irrigation systems have a number of disadvantages. The pouch is difficult to hide and to keep securely attached, and an odor of feces is frequently detectable. The pouch must generally be emptied or changed several times a day, depending on the frequency of bowel activity. In addition, difficulties in stoma self-care, skin irritation, decreased social relations and sexual problems are commonly reported by patients using the pouch.
WO 96/32904 discloses prosthesis for bowel evacuation control, which is inserted into the intestinal lumen, having a faceplate and a cover to prevent the feces escaping. Such a cover is unlikely to provide a reliable, watertight seal for long term use. Furthermore, it would be expected that build up of gas would occur within the bowel.
There is thus a widely recognized need for, and it would be highly advantageous to have, a stomal implant which is devoid of at least some of the disadvantages of the prior art.